Peer-mediated learning is an effective educational strategy that is rarely used during clinical training for medical students. We developed a peer-mediated learning conference, Student-Faculty Rounds (SFR), for the ambulatory component of a medicine clerkship. Designed to broaden students' exposure to common medical problems and provide practice in small-group teaching, the 30-minute conference is conducted by each student once during their clerkship. Students choose their topics and instructional formats, but they are advised to supply written learning objectives and employ interactive, problem solving opportunities. We analysed evaluations written by 280 students and 17 faculty supervisors during 1998-2001. Students presented over 150 topics. The most common were hypercholesterolemia, diabetes, headache, smoking cessation, hypertension management, and cancer screening (each presented in 3-4% of rounds). On a scale of 10 (outstanding) to 0 (lost cause), students gave SFR a score of 9.2 (95% confidence interval 9.0-9.3). In written comments, students indicated that topics were relevant and that peers provided instruction at an appropriate level of complexity, but that quality was variable. Faculty supervisors reported that 35% of students did not provide written learning objectives and 35% chose topics too broad for a 30-minute conference. SFR is a popular conference that accomplishes its educational objectives. It recognizes students' ability to educate themselves, and introduces variability and challenge into the classroom curriculum. Adequate faculty guidance is needed to assure students design conferences for maximum educational effectiveness.